For years, Victor G. Heiser's dreams were haunted by a single moment in the deadly flood that engulfed his native Johnstown 125 years ago today.
As the currents surged below, the 16-year-old Heiser clung from a roof "with my fingernails dug deep into the water-softened shingles, knowing that in the end I must let go," he later wrote.
He landed on floating wreckage -- one of a number of hairbreadth escapes in those desperate moments when the city was deluged after the failure of an upstream dam. More than 2,000 people, including his parents, were killed in Pennsylvania's deadliest disaster. As Heiser witnessed his neighbors going under, "there was nothing I could do for anybody."
It would not be the last time Heiser witnessed death-dealing of biblical proportions, but the last in which he felt so powerless.
Left an orphan by the 1889 Johnstown Flood, he worked in trades before finding his way to Jefferson Medical College in Philadelphia and then into the federal health bureaucracy. He soon was screening American-bound immigrants for infectious diseases at Ellis Island and in Italy.
By then competent in several languages, he was launched on his international career -- becoming a globe-trotting expert in public health and a best-selling author who lived to age 99.
The stoic yet genial Heiser used coercion and persuasion to combat smallpox, plague, cholera, malaria, beriberi and numerous other afflictions in the first half of the 20th century. He built the public-health system for the American colonial government in the Philippines between 1903 and 1915 and later worked for the Rockefeller Foundation, circling the globe at least 16 times as a self-described salesman for public health.
Early in his tenure in the Philippines -- after the United States wrested the archipelago from Spain in 1898 and then suppressed an indigenous uprising -- Heiser set a goal of saving 50,000 lives per year from preventable diseases. By his retirement, he was widely credited with saving more than 2 million.
Even today, decades after Heiser joined his parents in Johnstown's Grandview Cemetery in 1972, his legacy continues in the funding of research breakthroughs involving leprosy, a disease still active, particularly in poor countries, and the one line of work specifically named on Heiser's tombstone.
"My mission was to open the 'golden window of the east' to the gospel of health," Heiser wrote in his 1936 memoir, "An American Doctor's Odyssey," which sold half a million copies in 14 languages. He desired "that the teeming millions who had no voice in demanding what we consider inalienable rights should also benefit by the discoveries of science."
His writings can be perplexing to modern readers, using patronizing racial terms and descriptions that are beyond the bounds of today's civil discourse. His language used racial stereotype yet also opposed it.
Heiser described the Philippines at the time of his arrival in 1903 in apocalyptic terms.
"Across the street from my office was smallpox, to the right was plague and to the left cholera," he recalled.
He received, and used, dictatorial powers as the top public health officer. He oversaw a staff that eventually grew to 3,000, including 200 doctors. He put them to work starting inoculation programs, digging latrines, replacing street kiosks with more sanitary open-air concrete markets, sterilizing homes of cholera patients and promoting better diet to combat beriberi, a debilitating nutritional deficiency.
Heiser combated the skin-wasting disease of leprosy. At the time, it was treated with an effective but nauseating oil-based medicine. At Heiser's prodding, researchers produced an injectable form, which was widely used before modern antibiotics took its place.
Heiser also forcibly relocated Filipino lepers to an island colony -- admitting it was "cruel" to separate families but saying it was worse to expose others to the contagion. He then spent much of his budget to provide for the colony, visited it often and, in his journal, wrestled with self-doubt.
"There is much sadness that as yet I do not live in the hearts of the people. I wonder if I will ever be understood and if the lepers will sometime look upon me as their friend," he wrote.
"His regret is a vivid expression of the pathos of the progressive colonial bureaucrat," wrote University of Sydney historian Warwick Anderson in his 2006 book, "Colonial Pathologies," a critical study of American medical work and racial condescension in the Philippines. Heiser, Mr. Anderson wrote, never credited Filipinos with the ability to watch over their health even after decades of American tutelage and that he later exasperated superiors at the Rockefeller Foundation with self-promotion.
But Heiser was widely seen as heroic in his time and since -- honored by The Pennsylvania Society, lauded in book reviews and credited with inspiring a generation of public-health pioneers.
"I was under the spell of the Heiser charm, a charm that has sent armies of scientific men, great and small, to follow jungle trails all over this planet, and work until they drop," wrote one of his proteges, S.M. Lambert, in a 1941 memoir about his own public-health work in the South Pacific, "A Yankee Doctor in Paradise."
"There is a godlike something about Heiser that will never let him fall from the pedestal he deserves. Grant him clay toes if you wish, he is still a colossus [in] the field of public health," Lambert wrote.
When he returned to the United States after decades abroad, then in his 60s, he became an consultant on industrial hygiene. And the lifelong bachelor got married, to a wealthy widow, Marion Peterson Phinny, and they divided their time between New York and Connecticut before her death in 1965.
Heiser remained vigorous and alert deep into old age and served as an eyewitness source to historian David McCullough for his 1968 book, "The Johnstown Flood," the definitive narrative on the disaster. A recording of Mr. McCullough's interview of Heiser plays at the visitor center at the Johnstown Flood National Memorial, complete with a sculptural depiction of the young man clinging to flood wreckage.
According to Heiser's obituary in The New York Times, he attributed his longevity to regular exercise and spare eating -- "no desserts" -- while adding, in a rare but vague religious confession: "God has an awful lot to do with it."
He left about $3.5 million to seed the Heiser Program for Research in Leprosy, which has since funded $13 million in research in such areas as mapping the genome of Mycobacterium leprae, which causes the disease, and into more effective screening and treatment, particularly in the impoverished areas where leprosy most persists.
"If Dr. Heiser had not survived the flood, I don't think we'd know today what we know about leprosy," said Len McNally, who directs the program under the New York Community Trust.
Mr. McNally said he believes Heiser's bequest was inspired by his firsthand involvement in quarantining lepers.
"He cared deeply about the family destruction, the separation and removing of people from their families forever," Mr. McNally said. Working with lepers "was Dr. Heiser's passion, and until leprosy is cured, we will keep at it."
Peter Smith: firstname.lastname@example.org or 412-263-1416; Twitter @PG_PeterSmith.